SUMMARY/ABSTRACT PILOT AND EXPLORATORY STUDIES CORE (PESC) Evidence exists that patients with Alzheimer?s Disease and Related Dementias (ADRD) and other serious illness experience profoundly distressing symptoms that overwhelm them and their families. Pilot funding is needed in geriatric palliative care (GPC) to support investigators as they test the feasibility of new methodological or interventional approaches, to examine data for initial signals that support continuing to definitive studies, and to help junior investigators make the transition to independent funding. In this OAIC renewal application we propose a Pilot and Exploratory Studies Core (PESC) that builds upon our Mount Sinai OAIC 2015-19 experience that will accomplish the following aims: 1) support pilot and exploratory studies that a) examine the relationship between distressing symptoms and independence, function, and disability; b) develop interventions directed at distressing symptoms, quality of life, function, and independence for older adults with ADRD and other serious and chronic illness, and c) advance methods for the study of care of older adults with ADRD and other serious illness; 2) support the development of preliminary data in aging and palliative care that will lead to the development of larger research projects and career development awards focused on improving care and promoting independence for older adults with ADRD and other serious illness; 3) support junior faculty who are embarking on research careers in palliative care and aging, as well as mid- level and senior faculty who are embarking on research projects requiring pilot data or who are refocusing their work to fit within the OAIC theme; and 4) foster collaborative research among investigators from varied disciplines, specialties, and institutions. To accomplish these aims the PESC will: 1) solicit pilot studies from investigators within and outside the OAIC, with particular outreach to junior faculty; 2) review and select projects that fit the OAIC themes and support career development; 3) monitor study progress; and 4) assist in planning independent grant applications. We will give special consideration to projects that address two new cross-cutting OAIC themes: 1) the intersection between dementia and serious illness and 2) implementation science, and we will prioritize women and minority applicants. We will fund standard pilot applications (size: $50-75,000; duration: 1-2 years), and small pilot applications (size: $10-$25K; duration: 1 year), to permit rapid generation of pilot data and rapid response to RFAs. Mount Sinai?s faculty and programs in geriatrics, palliative care, population health, neurology, dementia, and psychiatry, and its affiliations with the Bronx VA Geriatrics Research Education and Clinical Center (GRECC), The Hebrew Home Research Division, The New Jewish Home Research Institute on Aging, and University of Rochester, will be a large source of potential PESC investigators.